TMC PRACTICE EXAM| 150 ACTUAL QUESTIONS & CORRECT DETAILED ANSWERS | 100% VERIFIED PDF

TMC PRACTICE EXAM| 150 ACTUAL QUESTIONS &
CORRECT DETAILED ANSWERS | 100% VERIFIED PDF




1. A 48 year-old female is admitted to the ED with diaphoresis, jugular venous
distension, and 3+ pitting edema in the ankles. These findings are consistent
with


A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances ANS Heart failure
2. A patient is admitted to the ED following a motor vehicle accident. On
physical exam, the respiratory therapist discovers that breath sounds are
absent in the left chest with a hyperresonant percussion note. The trachea
is shifted to the right. The patient's heart rate is 45/min, respiratory rate is
30/min, and blood pressure is 60/40 mm Hg. What action should the therapist
recommend first?


A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.


,D. Activate the medical emergency team to intubate the patient. ANS Needle
aspi- rate the 2nd left intercostal space.
3. All of the following strategies are likely to decrease the likelihood of damage
to the tracheal mucosa EXCEPT


A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures. ANS monitoring intracuff pressures.
4. A 52 year-old post-operative cholecystectomy patient's breath sounds be-
come more coarse upon completion of postural drainage with percussion. The
respiratory therapist should recommend


A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.






,D. deep breathing and coughing to clear secretions. ANS deep breathing and
cough- ing to clear secretions.
5. A 65 kg spinal cord injured patient has developed atelectasis. His inspira-
tory capacity is 30% of his predicted value. What bronchial hygiene therapy
would be most appropriate initially?


A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy ANS IPPB with normal saline
6. A patient on VC ventilation has demonstrated auto-PEEP on ventilator
graphics. Which of the following controls, when adjusted independently, would
increase expiratory time?

1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity ANS 1, 2, and 3 only
7. Which of the following would be the most appropriate therapy for a dyspneic
patient who has crepitus with tracheal deviation to the left and absent breath
sounds on the right?


A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube ANS Insert a chest tube
8. A 55 year-old post cardiac surgery patient has the following ABG results
ANS pH 7.50, PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14
g/dL, BE +2. Venous blood gas results are pH 7.39, PvCO2 43 torr, PvO2 37
torr, and SvO2 66%. Calculate the patient's C(a-v)O2.


A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol% ANS 5.0 vol%

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, 9. A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O,
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Pplat of 15 cm H2O and PEEP of 5 cm H2O. What is the patient's static
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lung compliance
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A. 25 mL/cm H2O BB BB


B. 35 mL/cm H2O BB BB


C. 45 mL/cm H2O BB BB


D. 50 mL/cm H2O ANS 50 mL/cm H2O
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10. Immediately after extubation of a patient in the ICU, the respiratory
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thera- pist observes increasing respiratory distress with intercostal
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retractions and marked stridor. The SpO2 on 40% oxygen is noted to
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be 86%. Which of the following would be most appropriate at this
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time?
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A. cool mist aerosol treatment BB BB BB


B. aerosolized racemic epinephrine BB BB


C. manual ventilation with resuscitation bag and mask
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D. reintubation ANS reintubation BB BB BB


11. Which of the following patients would most likely benefit from
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pressure support ventilation?
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A. An intubated patient with an absent respiratory drive.
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B. A patient on SIMV with a set rate of 12/min and total rate of 24/min.
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C. A patient with acute lung injury.
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D. A patient who requires short-term post-operative ventilatory
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support. ANS A patient on SIMV with a set rate of 12/min and total
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rate of 24/min.
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12. A patient receiving mechanical ventilation has developed a
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temperature of 99.9° F with purulent secretions over the last 12
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hours. The respiratory therapist has also noted a steady increase in
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peak inspiratory pressure. What initial recommendation should be made
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to address these changes?
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A. Initiate bronchial hygiene therapy. BB BB BB


B. Obtain a sputum gram stain. BB BB BB BB


C. Administer IPV. BB


D. Insert a CASS tube. ANS Obtain a sputum gram stain.
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13. Which of the following information may be obtained from a FVC
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